162301 20251017144606.0 doi 10.5114/jcb.2025.152539 sideral 144896 ART-2025-144896 eng Lozares-Cordero, Sergio Universidad de Zaragoza (orcid)0000-0002-1530-5662 A comparative cost-benefit analysis of electronic brachytherapy vs. high-dose-rate iridium-192 for exclusive vaginal cuff treatment in post-operative endometrial cancer 2025 Access copy available to the general public Unrestricted Purpose: To compare the economic and dosimetric aspects of electronic brachytherapy (eBT) and high-dose-rate (HDR) iridium-192 (192Ir) brachytherapy for exclusive vaginal cuff treatment in post-operative endometrial cancer patients. Material and methods: This retrospective observational study was conducted among 115 patients treated with eBT and 70 patients treated with HDR 192Ir between 2019 and 2023 at two institutions. All patients underwent 3 fractions of 7 Gy prescribed to a uniform target volume. Dosimetric parameters, including D90, V150, and V200 for high-risk clinical target volume (HR-CTV) as well as D2cc, D1cc, and D0.1cc for organs at risk (OARs), such as bladder, rectum, and sigmoid colon, were compared. Economic analysis focused solely on cost differences related to source replacement and maintenance, as all other procedural factors (i.e., personnel, clinical workflow, and logistics) were identical for both modalities. The cost of bunker was not considered in the analysis. Results: Dosimetric analysis revealed comparable target volume coverage between eBT and HDR 192Ir. The economic evaluation was focused on cost differences and their relative contributions. The relative average cost per patient under these assumptions was 18.4% lower for eBT (€273.9) than for HDR 192Ir, based on Spanish pricing, largely due to differences in source-related expenditures. Conclusions: While 192Ir HDR remains the standard in brachytherapy due to its versatility, eBT presents a cost-benefit alternative for exclusive vaginal cuff treatments, particularly in settings where infrastructure limitations restrict isotope-based brachytherapy. These findings support the complementary role of eBT in clinical practice, optimizing resource allocation without compromising dosimetric quality. info:eu-repo/semantics/openAccess by-nc-sa https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion González-Pérez, Víctor Sánchez-Casi, Marta González-González, Tomás Castillo Peña, Paula Pallarés-Ripollés, Mireia Herreros-Martínez, Antonio Pellejero-Pellejero, Santiago 1011 770 Universidad de Zaragoza Dpto. Microb.Ped.Radio.Sal.Pú. Área Radiol. y Medicina Física 17, 3 (2025), 160-167 J. contemp. brachytherapy Journal of Contemporary Brachytherapy 1689-832X 209213 http://zaguan.unizar.es/record/162301/files/texto_completo.pdf Versión publicada 2619521 http://zaguan.unizar.es/record/162301/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:162301 articulos driver 2025-10-17-14:15:42 ARTICLE